Resumen:
In Mexico, Diabetes is the first cause of death, and it is
estimated that the rate of mortality elevates 3% every year,
and this consumes between 4.7% and 6.5% of the national
health budget. Diabetes Mellitus is a chronic illness that
requires continuing medical care and ongoing patient selfmanagement
education and support to prevent acute
complications and to reduce the risk of long-term
complications. Diabetes care is complex and requires that
many issues, beyond glycemic control, be addressed.
In 2004, Mexico recorded 65,662 hospital discharges
with DM, of which 12,681 were due to Diabetic Feet
hospitalizations, with 5,327 amputations. In 2008, 6,223
amputations took place in private health institutions.
Diabetic Feet hospital discharges increased in 10% between
2004 and 2005, amputations due to DM also increased in
4%. With all this information we put in evidence the
importance of the nervous affectation in DM.
Studies done to look at the association of DM as an
etiologic factor for sleep apnea have suggested that
autonomic neuropathy may be a responsible for
dysfunction of central respiratory control of the diaphragm
and decreased upper airway tone. Somers et al. found that
sleep disturbance negatively affects glucose metabolism
and endocrine function. Other reports showed that 25% of
diabetic individuals with autonomic neuropathy have sleep
apnea, a proportion greater than in diabetic subjects
without autonomic neuropathy.
Diabetes may be a cause or consequence of SDB, or
possibly both. One study showed that experimentally
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induced acute sleep deprivation could cause a state of
glucose intolerance. Other studies demonstrated crosssectional
relationships between sleep apnea and both
fasting insulin and insulin resistance and between sleep
apnea and overt diabetes. Snoring, which is a common
symptom of SDB, has also been shown to predict the onset
of diabetes in both men and women.
Based on all of the above, this study is made in search
of an association between the clinical manifestation of
Diabetic Neuropathy and the disturbance of sleep quality,
speculating that sleep disorders in diabetic patients are
generated by damage to the nervous tissue, which
pathophysiologic mechanism shares similarity with that of
the Diabetic Neuropathy. Having at the same time
correlation with the degree of peripheral neural damage or
perhaps suggesting different mechanisms.
